The Treatment of Hirsutism With a Combination of Desogestrel and Ethinyl Oestradiol

Abstract

Some available oral contraceptive agents are unsuitable for the treatment of hirsutism since, although they suppress endogenous gonadotrophins and so ovarian androgen production, they contain a progestogen which is itself androgenic. The combination of 30 micrograms ethinyl oestradiol (EE2) and 150 micrograms desogestrel (Marvelon) does not suffer from this drawback. We have therefore assessed its value in 15 hirsute women treated for one year. Mean +/- SE androgen-dependent hair growth, assessed photographically fell from 0.31 +/- 0.01 to 0.23 +/- 0.01 mm/d at 1 year (P less than 0.001). Ten of the fifteen patients reported definite subjective improvement. Treatment was associated with a marked rise in SHBG concentration identical to that seen with 30 micrograms EE2 alone. By four months there were significant falls in serum levels of androstenedione and LH throughout the cycle, but not for testosterone, dihydrotestosterone or 5 alpha-androstane 3 alpha, beta 17 -diol. Calculated free testosterone levels were significantly suppressed. All the biochemical changes were maintained after seven months of treatment. We conclude that this preparation is a suitable oral contraceptive for the treatment of hirsute women.

Comparative study of the therapeutic effects of oral contraceptive pills containing desogestrel, cyproterone acetate, and drospirenone in patients with polycystic ovary syndrome

“…Ethinyl E 2 contained in the pill increases the SHBG level, resulting in the lowering of free androgen levels. But the clinical benefit may be blunted by the variable androgenic activity of progestogens in the formulation (16). The thirdgeneration combined pills containing desogestrel blocks the estrogen-mediated increase in SHBG to a greater extent than the other two pills because of the intrinsic androgenicity of desogestrel (17).…”

Salivary and Plasma Free Testosterone and Androstenedione Levels in Women Using Oral Contraceptives Containing Desogestrel or Levonorgestrel

“…4. 13 It has been suggested': 2. 13 that the higher available SHBG binding capacity for T and other androgens will lead to lower plasma free levels than in untreated subjects or subjects using LglEE2.…”

Hair growth and androgen responses in hirsute women treated with continuous cyproterone acetate and cyclical ethinyl oestradiol

“…Dewis et al (1985) have recently de¬ monstrated that desogestrel when used in combi¬ nation with ethinyl oestradiol is an effective progestogen for this condition and reductions in hair growth rate occur during its use in hirsute wo¬ men. Dewis et al (1985) have recently de¬ monstrated that desogestrel when used in combi¬ nation with ethinyl oestradiol is an effective progestogen for this condition and reductions in hair growth rate occur during its use in hirsute wo¬ men.…”